715 Plaza RERF18-0255 EREROOF SHINGLE PERMIT PERMITNUMBER
CITY OF ATLANTIC BEACH RERF18-0255
, _ 800 SEMINOLE ROAD ISSUED: 10/31/2018
ATLANTIC BEACH. FL 32233 EXPIRES:4/29/2019
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
that may be found in the public records of this county,and there may be additional permits required from other
governmental entities such as water management districts,state agencies,or federal agencies.
715 PLAZA REROOF SHINGLE SHINGLE ROOF
$9479.00
1711240000
• ROYAL PALMS UNIT 01
. . •
K& D ROOFING &
CONSTRUCTION 2758 DAWN RD SUITE 1NE JACKSONVILLE FL 32207
MLZMMMMM
• . . •
KOHN CHARLES A JR 715 PLAZA ATLANTIC BEACH FL 32233.3907
=BEFORERECORDING
WNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
NT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
RE RECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF CONDITIONS
R011 off container company must be on City approved list. Container cannot be placed on City right-of-way.
FEES
DESCRIPTION ACCOUNT QUANTITY
BUILDING PERMJi PAID AMOUNT
455-0000-3231000 0 $10000
51giE OBPR SUflCHAgGE 455-0000-1080700
0 00
STATE DCA SURCHARGE 955-0000.108-0600 0
$1.00
TOTAL:$106.00
Issued Date10/31/2018 1 of 2
Building Permit Application
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: I S PIQ- - }t Br R 617 F i 8 �O ZSS
Pernik Number. 11�� o JJ
Legal Description �4� 1-7-.7"a 1 �^i3- 1
REx
Valuation of Work(Replacement Cost)$Q_y7q. lQ Heated/Cooled SIP
Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structures)(Circle one): CommercialResidential
• If an existing structure,is afire sprinkler system installed?(Circle one): Yes No /A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the ryoe of work to be pertormed:
REROOFING 50 YR SHINGLES
Florida Product Approval k FL 10124R7/FL.UNDERLAYMENT APFROVALa FL18681F1 for multiple products use product approval form
Pro a 4ner lnformat onPro e: j ft Address: JrCiryLa�-NL Pv� 1 State
E-Mall_ Iyi L!f Zip ;417 +5 Phone
Own o Age t(IfAgent,Power ofAttorney or Agency Letter Required)
Contractor Information
Nameof Company: KBD RDOFINGS CONSTRUCTDN LOMPANI' INC Qualifying
Address 74msTnEErWUTN,SUREfoe Agent: I:oean Mie,Owner/P�eN4em
Office Phone soa 1-1700 Ciry . CKSOWLIE BEACH State FL tip 3pAo
Job Site/Contact Number
State Certification/Registration g CCC lazsasz E-Mail rt �nwmaitmm
Architect Name&Phone 4
Engineer's Name&Phone N
Workers Compensation
Exempt/Insurer/lease Employees/EgNMlon Date
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will he performed to meet the standards of all the laws regulatlong
acnrtructlon in this jurisdiction.l understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT:I certify that all the foregoing Information is accurate and that all work will be done in compliance with all
applicable laws regulating constmcdon and zoning.
WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDI G YOUR NOTICE OF COMMENCEMENT.
(Signature ofO tier or Fgent including Contractorl (Signature of Contmcwrl
Signed and sworn to(or affirmed)before me this�L day of Signed and sworn to(or aRrmed)before me this
A' iw-- Ab IIII [tJn ?t dayof`
(Signature of Notary)
far'COa401S8pN a fNNkQ7S2
ExPNtES Mtagh ta.:IOIf t.: LORI W ... T
erson 7-�personally Known 08 MY COMMIS$pN tOODgr3E6
I Produced ltlentiflca[lon ( Produoetl ldentifiration •'+.. EXPIRES
Type of Identification- Type of ldentifi®tion: March 37.2021
(P 11\CATE) �GD1GA 1
(PREPARE IN pUPLICATEI
Permit No.
$tate Of FIOaIDA Tax FOIIO NO
COunry of
To whom It may cone...:
The undersigned hereby Informs you that Improvements will be made to certain real P.OPerly,and In
accordance with Section 713 of the Florida Statutes,the following Information is stated In this NOTICE OF
COMMENCEMENT.
Legal description of propeM being improvetl:
n �4 P1 W,
Address Of property being improved: I�} P IA7 A � _ f
--='-'-ss' -.-.-,ic..�E,s��13223 3
General de�5cdptam Of improvements:w'ROOF/50 YR SIIINGIM
Owner
Add '7 SPI 0-2 q}I eInra "h rs1 �..;.�.
Owners interest in sit. f the Improvement OWNER
Fee Simple Titleholder Of other than owner],
Name
D
Address
1 �($RPxryu,rdljJ COnhactor K,\0 RODFING R CONSTRIICI'ION ,1v INC.
—J Atltlress 746FI1Sf0EET50VfN,SHITE 104 JpCKSONV11.lE 0F.AGI,FI,J22'u11
Phone NO. ed451tr>OggM.zaa-epee
Fax No. 'JIN'0090249 EfA%
Surety(if any)
Address
Amount of bond$
Phone No.
Fax No.
Name and address otany person making a can for the construcpon of the imprevemanls.
Name
Address
Phone No. Fax NO.
Name of person within the State of FiOrida.other than himself,designated by owner upon whom notices or Other
docoments may be served:
Name
Atltlress
Phone No. Fax No.
In addition to himself,Owner designates the fWlming person to receive a copy,of the Lienors Notice as Provided In
Section 713 O6(2)(b),Florida StaNtes.(Fill in at Owners Option).
Name
Atltlress
Phone No. Fax NO
Expbation date of Notice Of Commencement(the expiration date is one(t)year from the data or recording unless a
different date is specified):
TNI99PACE FOR RECORDER'S USE ONLY
e0 NE p
5
PATE, 2,G 1Z CIf
smra m.mi. p
anG nary 1Slaro orF 06 nr eppN�ed
NmaN(' a Vaam Mtl Ml Imam¢aeM oxionsone nwTm to ey
o-w em av�,ma
One k 2018258670,OR BK 18582 Page 1048,
Number Pages:I
Recorded 10/Ii 1802:40 PM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL xoury Nic an ley.,aroneN l,DRlpp C.
COUNTY "IY tcmmisSM axgrn:. ",y.
FVbmey K.
RECORDING $10.00 weev.ad l4ansnuaw _nr
ROBERT:HILE7MY COMMISSIO762EXPIRES Marc